Abstract: Large artery atherosclerosis (LAA) and white matter lesions (WML) involves different vessels with different pathophysiological mechanisms. However, the structurally and functionally connection of the different blood vessels and the common vascular risk factors of the two conditions suggest that they are inter-mingled and should be considered together. The possible risk factors of coexisting WML in patients with LAA include the occurrence of LAA contributing to WML progression, or more or severer vascular risk factors and genetic factors play important roles on the coexisting conditions. This article retrospectively reviews the basic and clinical researches in this field and summarizes the advances in risk factors of the coexisting conditions.